People with Hepatitis B denied dental treatment
Experts point out proper sterilisation of dental tools before reuse
Nazmin, 18, from Khulna visited the city's Sapporo Dental College and Hospital last year to pluck one of her teeth. When she disclosed that she is a Hepatitis B positive, the on-duty doctor referred her to the Birdem Hospital.
For one month Nazmin was being referred to one hospital to another and no doctor plucked her tooth. "Every hospital told me that they have not enough equipment to support me without explaining the special equipment," said Nazmin.
The doctors were avoiding Nazmin due to fear of spreading the virus. Most of the hospitals lack proper isolation units and most importantly they didn't want to take the risk.
"As our college does not have proper equipment and instrument to support a case of viral hepatitis (B), we thereby refer this case to the Birdem Hospital (Dental unit)," reads the prescription of the dental hospital.
But a senior doctor told this correspondent that no separate equipment was needed to pluck Nazmin's tooth. They could pluck the tooth with their existing tools after proper sterilisation.
The doctor who wrote the prescription told this correspondent that he did not dare to treat the patient fearing spread of the virus in the air and as they don't have disposable hand piece (dental drill), three-way syringe etc.
"As this is a new hospital and don't have proper equipment in this regard. It could create problems for other patients as Hepatics B is a contagious disease," he said adding that they also refer patients with Hepatitis C and HIV.
The hospital authorities have to ensure that one patient does not infect others at the hospital. The ideal procedure is to treat these patients in an isolated condition. But as they are yet to set up any isolation corner, they are referring patients to the hospital where it is maintained, he said.
Talking to The Daily Star Prof Shamsul Alam, dean, Dental Faculty of Bangabandhu Sheikh Mujib Medical University (BSMMU), said such patients should be treated after taking cautionary steps. Even, the patients can be asked for procuring the tools on their own which would not be used later. But they must get treatment on emergency basis, he added.
Otherwise, these patients would hide their status for receiving treatment, which would be worse and perilous, he said.
A patient can be referred to another hospital for better treatment. But if all hospitals try to refer such patients, they ultimately would not get treatment, said Dr Shamsul.
Stressing the need for sterilisation, Dr Shawkat Mamun, outdoor dental surgeon of Dhaka Medical College and Hospital, said sterilising the equipment after treating every patient is a general rule. The dental hospital at least could screen whether the virus was active or not before referring her to another hospital.
Referring to some researches, retired professor of the department of Hepatology of BSMMU Dr Mobin Khan showed that now 1.5 crore people are infected with Hepatitis B.
If sterilisation system cannot be improved at every public and private hospital and isolation corner cannot be set up accordingly, the number would increase, he added.
This is same for the people living with HIV/AIDS or other deadly infectious diseases. Now more than 2,000 people are living with AIDS. If they don't get treatment disclosing their status, certainly they would go for unfairmeans, said Habiba Akhter of Ashar Alo Society, an organisation working to ensure the rights of people living with HIV and AIDS.
When asked about isolation corners at all the hospitals and clinics, Deputy Director (hospital and clinic) Lutful Kabir said during the outbreak of swine flu, isolation corners were set up at every district hospital. But it was not a permanent mechanism.
"As there is nothing in the Hospital and Clinic Act 1982 regarding isolation corner, we have nothing to do actually," he said.
He also said the law is waiting for amendments but unfortunately it did not incorporate the issue of establishing isolation corners to prevent spread of infection in the hospitals.
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